Trastuzumab
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Decreased left ventricular ejection fraction and cardiac failure: 7 case report In a retrospective cohort study of 110 women with human epidermal growth factor receptor-2 (HER-2) positive early breast cancer, who started receiving trastuzumab between April 2006 and May 2007, 7 women [exact ages not stated] were described, who exhibited decreased left ventricular ejection fraction (LVEF) during treatment with trastuzumab. Out of these 7 women, two women subsequently developed cardiac failure. The women, who had HER-2 positive early breast cancer, had previously received unspecified anthracycline based chemotherapy. Later, the women started receiving treatment with trastuzumab at a loading dose of 8mg/kg followed by 17 three weekly cycles at 6 mg/kg [route not stated]. Eventually, the women exhibited decreased LVEF. An insufficient recovery of LVEF was noted. Two of these 7 women, were subsequently diagnosed with class II (n=1) or class III (n=1) symptomatic cardiac failure according to New York Heart Association (NYHA) [duration of treatment to reactions onsets not stated]. The women’s trastuzumab treatment was stopped. Thereafter, both women, who had symptomatic cardiac failure, were treated with unspecified cardiac medications. Six months later, cardiac failure symptoms resolved with improvement in LVEF. Author comment: "Using the established protocol, 78% of patients completed trastuzumab on schedule and 17% of the cohort required treatment delay because of concerns regarding cardiac safety with 6% failing to complete trastuzumab because of insufficient LVEF recovery despite delay. Only 2 patients developed symptomatic heart failure which recovered with medical therapy." Murray LJ, et al. Adjuvant trastuzumab in routine clinical practice and the impact of cardiac monitoring guidelines on treatment delivery. Breast 19: 339-344, No. 5, Oct 2010. Available from: URL: http://doi.org/10.1016/j.breast.2010.02.001 803437885 United Kingdom
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Reactions 7 Dec 2019 No. 1782
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